Qu Lu, Chen Huiying, Miller Haylie, Miller Alison, Colombi Costanza, Chen Weiyun, Ulrich Dale A
Institute of AI for Education, East China Normal University, Shanghai, China.
School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.
Front Psychol. 2022 Jul 28;13:859145. doi: 10.3389/fpsyg.2022.859145. eCollection 2022.
Parent-mediated intervention (PMI) has been studied in promoting skill acquisition or behavior change in the children with autism spectrum disorder. Most studies emphasize on the improvement of child's core symptoms or maladaptive behaviors, making parental perceived competence and self-efficacy secondary. Yet, the evaluations of intervention implementation are under-reported, especially when translating such interventions into a new population or context. This research investigated the intervention implementation of a 12-week parent coaching intervention which was delivered through telehealth and tailored to Chinese population. The intervention was based on the Parent-mediated Early Start Denver Model with culturally adapted lectures, manuals, and demonstration and commentary videos. This study aimed to evaluate the intervention implementation by assessing parents' satisfaction, acceptability, appropriateness, and feasibility.
A randomized controlled trial was conducted with two telehealth conditions: self-directed and web+group therapy. Parents in the self-directed condition received intervention individually through the online learning platform. The web+group therapy condition navigated the same program with weekly 1.5-h group coaching sessions videoconferencing. This mixed-methods study used a concurrent convergent design to evaluate the intervention implementation at post-intervention. The quantitative data was collected from the Program Evaluation Survey and the qualitative data was collected from five focus groups.
Parents in self-directed group reported significantly lower scores in total perceived competence than parents in web+group therapy condition, while there was no group difference on the total self-efficacy. , and were the top-five acceptable telehealth strategies that were strongly endorsed by parents. , and were elements that parents considered when evaluating the program's appropriateness. were key components in making intervention strategies feasible for parents to implement at home.
Findings indicate the application of telehealth was acceptable, appropriate, and feasible for Chinese parents. Group-based parent coaching intervention videoconferencing could be a promising home-based service model to increase parental perceived competence. A large-scale RCT is needed to investigate the effectiveness of group-based PMI telehealth.
父母介导干预（PMI）已被用于研究促进自闭症谱系障碍儿童的技能习得或行为改变。大多数研究强调改善儿童的核心症状或不良行为，而将父母的感知能力和自我效能放在次要位置。然而，对干预实施情况的评估报道较少，尤其是在将此类干预措施应用于新的人群或环境时。本研究调查了一项为期12周的通过远程医疗提供并针对中国人群量身定制的父母指导干预措施的实施情况。该干预措施基于父母介导的早期丹佛模式，并配有经过文化改编的讲座、手册以及示范和讲解视频。本研究旨在通过评估父母的满意度、可接受性、适宜性和可行性来评价干预措施的实施情况。
进行了一项随机对照试验，设置了两种远程医疗条件：自主指导和网络+小组治疗。自主指导组的父母通过在线学习平台单独接受干预。网络+小组治疗组通过视频会议参加每周1.5小时的小组指导课程，学习相同的项目。这项混合方法研究采用了并行收敛设计，在干预后评估干预措施的实施情况。定量数据通过项目评估调查收集，定性数据通过五个焦点小组收集。
自主指导组的父母在总感知能力方面的得分显著低于网络+小组治疗组的父母，而在总自我效能方面两组没有差异。 、 和 是父母强烈认可的前五项可接受的远程医疗策略。 、 和 是父母在评估项目适宜性时考虑的因素。 是使干预策略便于父母在家中实施的关键组成部分。
研究结果表明，远程医疗的应用对中国父母来说是可接受、适宜且可行的。基于视频会议的小组父母指导干预可能是一种有前景的家庭服务模式，可以提高父母的感知能力。需要进行大规模随机对照试验来研究基于远程医疗的小组父母介导干预的有效性。
